Book review: The One Thing We’ve Never Spoken About, Elfy Scott

Complex mental health conditions are explored in this book that melds personal stories with wide-scale investigation.

Every so often, you encounter a book and feel some surprise that it hasn’t been written before. Around half of Australians are predicted to experience a mental health condition at some point in their lives. Although less common than anxiety and depression, complex and severe mental illnesses are experienced by 800,000 Australians. And while billions of state and federal funding has been funnelled into mental health, it isn’t clear how this money has improved lives across the board. It’s a vital issue, but as the title of Elfy Scott’s investigation into the mental health system claims, it’s The One Thing We’ve Never Spoken About

Scott’s far-reaching investigation begins at home. Scott’s mother experienced the onset of schizophrenia shortly after migrating to Australia, in the years before Scott was born. Although the family knew of the diagnosis, it was treated as an ‘open secret’, referred to vaguely as ‘her voices’ or ‘her illness’. It was only more recently that Scott involved herself in her mother’s care, and became curious about the experience of psychosis and other symptoms of schizophrenia. 

This family life is a microcosm of the way schizophrenia and other persistent, severe mental illnesses are treated broadly in Australia. It’s something most people have heard of, but few understand. Efforts to reduce the stigma around anxiety and depression haven’t penetrated to these more complex experiences. Scott’s and her mother’s lived experiences powerfully anchor broader discussions about mental health system dysfunction, finding social support, unhelpful stereotypes about psychosis, police violence towards those with mental illness and the criminalisation of symptoms, issues with housing and the stresses placed on carers. 

Scott argues that stigma is at the heart of issues with the mental health system. The fact that people feel pressured into silence about their experiences, that those experiencing psychosis are incorrectly portrayed as dangerous, that the general public makes little effort to understand what psychosis is like, makes true reform challenging. There is not enough of a public groundswell to support this vulnerable population, or to believe in their recovery. 

Scott draws on the stories of those with lived experience of severe and complex mental health conditions and their carers, which serve to run counter to stigmatising attitudes, making human interviewees vibrant in the midst of an ongoing dehumanising conversation about mental illness. 

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The book is by turns affirming and hopeful, and heartbreaking. It includes stories of those who have learned to cope with difficult experiences and those who have found pride in their identities, as well as those who have experienced homelessness, discrimination and early death. It is an intense read. But Scott’s vivid voice, which threads a friendly authority throughout the multiplicity of stories and research, makes this essential book remarkably approachable. 

The One Thing We’ve Never Spoken About: Exposing Our Untold Mental Health Crisis by Elfy Scott
Publisher: Pantera Press
ISBN: 9780645240108
Format: Paperback
Pages: 324pp
RRP: $32.99

Release Date: 31 January 2023

Erin Stewart is a Canberra-based freelance writer and researcher.